Science, Medicine, and Anthropology

My research in Việt Nam addresses how medicine, health, and disease function as political and cultural signifiers as well as telegraphing – in the form of epidemiological data and public health outcomes – important features of the socioeconomic order. While health and disease are highly politicized everywhere in the world, these issues take on intriguing significance in socialist and formerly socialist settings – in part because they reveal the cultural features of a political economic system whose heyday is increasingly difficult for North Americans to imagine. Though Việt Nam’s status as a socialist country is complex, certain features of the socialist period remain influential. At the same time, Việt Nam’s transition to a capitalist economy has radically reshaped key social institutions – with concomitant radical changes for the way people live, work, consume, experience health and illness, and experience their bodies in everyday ways. To say this more simply, health – as a physical state of being as well as a social and cultural ideal – is politics by other means. My research addresses how transformations in Việt Nam’s national political economy have affected public health outcomes, the organization of the health sector, and the cultural idea of “health.”

The author with Lý Thị Mai(pseudonym), 57. “I want our nation to develop so the health services can have doctors return to lower levels. The hospitals are far, kilometers away. We should have many hospitals and health stations close to the people in their districts, and they should have excellent doctors so people could be treated quickly and be cared for better.”

To ask “How are you?” in Vietnamese, one asks “Are you healthy?” When I started fieldwork in Hà Nội in 2008, I confess I lacked a nuanced understanding of what the seemingly straightforward concept of “health” might mean in this complex sociocultural setting. My fieldwork – which entailed ethnographic interviews with poor and working-class families as well as with Vietnamese specialists in medicine, public health, and epidemiology – helped me form grounded impressions of how these issues matter locally. As I have come to understand it, health and disease are culturally meaningful insofar as they resonate specifically with complexes of ideas and values that are essentially ethical, political, and philosophical – about, for example, personhood, gender, deservingness, fate, and the proper role of society and the state respective to citizens’ private lives (c.f. Lincoln and Lincoln 2015). The research that I have published on the more empirical aspects of health in Việt Nam has argued that infectious disease epidemiology reveals the shifting priorities of the national health sector, that the respective states of more and less prestigious health facilities betray the effects of new disparities in health care financing, and that the state’s management of poverty and public health exposes shifts in commonly held conceptions about morality, the public sphere, and the terms of the social contract.

In addition to expansion at first use, some publications also have a key listing all acronyms used therein and what their expansions are. This is a convenience to readers for two reasons. The first is that if they are not reading the entire publication sequentially (which is a common mode of reading), then they may encounter an acronym without having seen its expansion. Having a key at the start or end of the publication obviates skimming over the text searching for an earlier use to find the expansion. (This is especially important in the print medium, where no search utility is available.) The second reason for the key feature is its pedagogical value in educational works such as textbooks. It gives students a way to review the meanings of the acronyms introduced in a chapter after they have done the line-by-line reading, and also a way to quiz themselves on the meanings (by covering up the expansion column and recalling the expansions from memory, then checking their answers by uncovering). In addition, this feature enables readers possessing knowledge of the abbreviations not to have to encounter expansions (redundant to such readers).

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